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[Bartonella endocarditis on native valves. Apropos of 2 cases]
P Berdagué1, D Clavé, M Archambaud
1CHU Rangueil, Toulouse.
Archives Des Maladies Du Coeur Et Des Vaisseaux
|December 2, 1998
Summary
Bartonella endocarditis can affect native heart valves, particularly in individuals with poor living conditions. Early diagnosis and treatment are crucial, even with negative blood cultures, to prevent severe cardiac complications.
Area of Science:
- Infectious Diseases
- Cardiology
- Microbiology
Background:
- Native valve endocarditis (NVE) is a serious infection.
- Bartonella species are increasingly recognized as a cause of NVE.
- Diagnosis can be challenging, especially with negative blood cultures.
Observation:
- Two cases of Bartonella endocarditis in native valves are presented.
- Case 1: A 15-year-old girl with poor social conditions presented with pyrexia, congestive heart failure, mitral regurgitation, pulmonary hypertension, and pulmonary valve vegetations.
- Case 2: A 39-year-old homeless man with alcoholism presented with recurrent ischemic stroke, aortic regurgitation, and aortic valve vegetation.
Findings:
- Etiological diagnosis of Bartonella was confirmed post-hoc via high antibody titers and genetic amplification.
- Both patients required valve surgery after antibiotic therapy.
- Negative blood cultures necessitate systematic Bartonella investigation in at-risk populations.
Implications:
- Highlights the importance of considering Bartonella in culture-negative endocarditis.
- Emphasizes the need for targeted diagnostic approaches in vulnerable populations.
- Underscores the potential for severe cardiac sequelae if Bartonella endocarditis is missed or delayed.